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Can We Have a Civil Debate Over Home Births?

In a month filled with news relating to home births, several thoughtful writers have been trying to bring some light to the often heated discussion about the topic.

According to the Centers for Disease Control and Prevention, home births have gone up 29 percent in the United States since 2004 (although they remain less than 1 percent of births overall). With the news of that increase inevitably comes a renewed debate over the safety of home birth, and amplifying that concern was the death of a home-birth advocate in Australia from a heart attack just one day after giving birth at home.

Emily Willingham, writing first for Slate, and then on her own blog, The Biology Files, calmly advocates for making “safe” home birth (with a big emphasis on the “safe” part) an option for more women. As a voice in support of home births, she’s refreshingly non-polemic, and concerned about the potential problems with home births that aren’t supported by a certified nurse-midwife.

Home birth in the United States is, in practice, several different entities. The spectrum runs from women birthing unattended — which is both dangerous and counter to a long, multicultural tradition of woman-supported birth — to what I’d consider the gold standard: certified nurse midwife, backup from a hospital-affiliated OB and a well-equipped hospital nearby.

Ms. Willingham would increase women’s access to certified nurse-midwives for home births, but she also advocates gentler, less-interventionist approaches in hospitals nationwide — an approach that might change the calculation for some women. As Ceridwen Morris, a childbirth educator and noted crunchy-but-generally-reasonable voice on birthing topics, responded for Babble:

Yes! I’ve been saying this for years. Even if home birth was a real option for a segment of the population in the U.S., we still need to work on hospital care and outcomes. Fewer women would be opting out of hospital births if they didn’t feel their births would be overly medically managed to the point of introducing new risks from medications and surgery.

Many women (myself included) would never choose a home birth, but those who are considering or embracing it often feel as though their reasoning is quickly dismissed by the mainstream public and the medical establishment. As a result, much of the discussion tends toward the shrill or the defensive. Ms. Willingham’s work is a rare thing: a thoughtful, tempered consideration of home and hospital birth from someone who’s done both. She supports some home birth while advocating intelligently for improved hospital birthing conditions for all.

Equally thoughtful, but tipping the scales in the other direction, is Kimberly Gerson’s “Where Were You on Your Birth Day.” Ms. Gerson gave birth at home in 1983, and while she too advocates for safety in home births and less intervention in hospital care, she has come to believe, in the nearly three decades since she had her daughter, that a hospital or well-equipped birthing center is “absolutely the right place for many women to have their babies.”

Home birth went from an option to a belief system. And the trouble with that is that people who share a strong belief system tend to reinforce each other and shun anything that is contrary to their belief, no matter how grounded in reality the new information is. With that comes a closed mindset that says you are either in or out; there is no in between.

It’s that closed mind that both Ms. Willingham and Ms. Gerson avoid, and that’s what makes their work such a valuable addition to the multitude of voices online on both sides of what’s long since become a strident home-birth debate.

You can follow links from both into a broad spectrum of views on home birthing, perfect for reading prior to a discussion with a health-care provider. The making of an informed choice, based on your circumstances and the care available — which, depending on where you live and your health insurance, can vary dramatically — might be easier when the debate is framed more by information than by passion.

About

We're all living the family dynamic, as parents, as children, as siblings, uncles and aunts. At Motherlode, lead writer and editor KJ Dell’Antonia invites contributors and commenters to explore how our families affect our lives, and how the news affects our families—and all families. Join us to talk about education, child care, mealtime, sports, technology, the work-family balance and much more